Everything You Need To Know About Premature Ejaculation

Everything You Need To Know To Last Longer In Bed

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You're about to finally seal the deal with a new partner. Things are going beyond great — you two are totally feeling each other, and you can't wait get home to your place and finish what the two of you started at the bar. But as soon as things get going, you realize that it's all happening too fast — and you can't stop yourself from finishing early.

"I swear, this usually never happens," you say, an apologetic look on your face. Not the end to the evening you were hoping for, right?

It's embarrassing, but it happens. In fact, according to a recent study, premature ejaculation affects 20% to 30% of the U.S. population. In the short term, PE can mean a disappointing night. But the longer the problem persists, the more likely it is to have a negative impact on the relationship you have with your partner, impact your self-esteem and can cause long-term stress.

The key to getting a handle on premature ejaculation is to understand what it is, what causes it and what can be done in order to prevent it from happening. Here's a guide to everything you need to know about premature ejaculation.

Contents

1. What Is Premature Ejaculation?

Medically speaking, premature ejaculation is determined by two things — the lack of control a man has over when he ejaculates, and whether or not he and his partner are satisfied with the duration that he lasts for. According to urologist Dr. Peter Stahl, there are different varieties of this condition. "Premature ejaculation comes in two variants: lifelong and acquired, which have slightly different definitions," he explains. "Lifelong premature ejaculation is generally defined as ejaculation that almost always occurs within one minute, is difficult or impossible to delay, and is associated with distress or bother. Lifelong premature ejaculation is a true neurobiological predisposition to ejaculate early. Acquired premature ejaculation is different and usually related to anxiety or other sexual dysfunction."

As far as the amount of time that qualifies as ejaculation being premature, sexual psychophysiologist Dr. Nicole Prause says that there isn't a medically accepted amount of time that dictates this disorder. "There is no standard number of intromissions (intravaginal strokes) or latency (time to ejaculation) that is recognized as [premature]," she explains. "This definition is usually left to the male reporting distress. Of course, this is very problematic. A series of laboratory studies actually found most men who believe they have [premature ejaculation] actually did not orgasm more quickly to vibratory stimulation than men who did not believe that they had a problem in laboratory studies." There's also no medical test for premature ejaculation currently available. But if both you and your partner are unsatisfied with the amount of time that you're lasting, this means that it's a problem for both of you — so you'll want to take the necessary steps to address it.

What Real Women Say: "I dated a guy once who wouldn't sleep with me for several months," says Casey, 26. "While I usually don't rush into things sexually with new partners, I did think that the behavior was strange — to the point that I questioned where things were going, and whether or not he was actually interested in me. When we finally did sleep together it became extremely clear that the reason why he wasn't rushing to do the deed was that he finished very quickly. We did it again a few more times and the same thing kept happening — although I did find that the more we drank beforehand the longer he lasted, though it still wasn't ever anywhere beyond a few minutes long. In retrospect, I should have said something — I would've been willing to try things that would have maybe helped. But instead we started to see less and less of each other until things ended."

2. Why Does It Happen?

As Dr. Stahl explained, there are two different types of premature ejaculation. One is caused by a neurobiological predisposition to ejaculate early. If you have this type of premature ejaculation, it's likely something that you've experienced since you first became sexually active. But as for acquired premature ejaculation, there are plenty of factors that can cause this. "Acquired premature ejaculation, in contrast, can be caused by relationship anxiety, intensity of arousal, and other sexual dysfunction," Dr. Stahl says. "Erectile dysfunction is actually commonly associated with acquired premature ejaculation, and treatment of the erection problem often cures the ejaculatory problem."

Another factor that can cause premature ejaculation is when the body's sympathetic response (our body's "fight or flight" reaction) is triggered during sex. "Sexual contact makes most everyone have some sympathetic arousal," explains sex therapist Michael J. Salas. "However, for some, this can happen even more rapidly, with more intensity. With so much intensity, the body does what it needs to do to deactivate some of this arousal. It can come from a variety of sources. Sometimes the person has some hangups about sex. Sometimes it's simply the type of touch that was offered. And it can even be below the surface issues and insecurities that the person isn't even aware of."

Premature ejaculation can also happen due to complications with feeling the physical signals that you're going to ejaculate. "Some men who have premature ejaculation have difficulties with the sensations that tell most men that they may reach a point of sexual 'no return," Salas explains. "Meaning that they have to ejaculate if they cross this point."

"Prevalence is slightly higher at younger age, but [premature ejaculation] tends to be pretty stable across age," says Dr. Prause. "Most remarkably, men with [premature ejaculation] consistently report more problems with anxiety in general, including with their bedroom 'performance.' "Hyperthyroidism and some medications can contribute. With respect to partner factors, men with [premature ejaculation] are more likely to feel less informed about female sexuality and have a more sexually experienced female partner."

According to tantra instructor Helena Nista, personal masturbation habits also come into play with premature ejaculation. "Many men first learn to self-pleasure when they're teenagers and they form a habit of touching themselves in a very quick, efficient way in order to avoid getting caught," she says. "As they continue masturbating exactly the same way for many years, their nervous system becomes wired in a way that leads to a quick release and they lose control over their arousal."

The type of porn you watch — and the frequency at which you watch it — may also be contributing to the problem. "Porn is a great source of sexual stimulation and can lead to high levels of arousal," says Nista. "When overstimulated, men become highly excited very quickly, leading them to a premature climax. When this process is repeated often, the body adopts it and performs the same way each time — whether the man wants to release quickly or not."

What Real Men Say: "I used to literally go for hours," says James, 32. "Since I got Type 1 late-onset childhood diabetes it's been, well, quite the opposite. I've tried Fluoxetine/Prozac in high doses, but to no avail. Cialis didn't address the issue either. It's really put a damper on my sex life. Especially when I'm used to it being a good one. I might try some lidocaine gel but then it would be only for my girlfriend — probably nothing but exercise followed by a poor excuse for an orgasm for me. I also may try another prescription."

3. What Does It Mean About Your Masculinity?

You know what it is and what causes it — but regardless of the facts, the social stigma that premature ejaculation somehow means you're less of a man is still something that those who suffer from this problem have to deal with.

But clinically speaking, premature ejaculation doesn't mean that you're any less masculine. "Premature ejaculation says nothing about masculinity at all," says Salas. "Although, many men are shamed for it, and ashamed of it. In working with this, it's important to help people understand that sex is a broad array of connection that is more than just intercourse. While working on premature ejaculation, people can still enjoy their sexual experiences."

Nista says that the amount of pressure that both society and men put on themselves can be very problematic for those suffering from premature ejaculation. "I have worked with men who have come to me in a state of depression, self-conscious and unable to approach women out of fear or embarrassment," says Nista. "That fear is very telling about how we perceive masculinity and the pressure we put on men to perform in bed. We expect men to be great lover and to satisfy their partners, however, the society gives them no tools or education to create mind-blowing, long-lasting sex in the bedroom. Some men give up on relationships, unable to deal with shame and embarrassment."

Experiencing premature ejaculation delivers a blow to one's self-esteem — and can have long term effects. "Men want to be known for their prowess," says holistic practitioner Sheri Brown. "When a man feels he cannot perform or satisfy sexually they feel like a failure. This wreaks havoc with a man's self confidence. Men start avoiding sex, feeling depressed and have anxiety when they think about sex. This can create a mental anxiety that lasts longer than the original cause of the symptoms."

What Real Women Say: "When we first met, my now husband was dealing with premature ejaculation," says Krista, 31. "We worked in the same office building, and after the first night we had sex he didn't speak to me for days afterward. I finally cornered him in the parking lot (which he still jokes about) being like what the hell? We had a straight up conversation about it, and he admitted that he hadn't seen a doctor about it. It turns out it was actually a simple fix — switching the medication that he was on. But had he gotten this checked out earlier, he probably wouldn't have been single when I met him."

What Real Men Say: "Premature ejaculation is definitely a rough thing to deal with, and while it shouldn't really feel this way, it does have an affect on how masculine you feel," says Sam, 29. "It makes you feel really terrible, because you think that a man should be able to last long enough to give adequate pleasure to the person he's having sex with. It's borderline impossible to feel ultra-manly if you've just gotten off way too quickly."

4. Products That Help Prevent It

As with any sexual issue people experience, a number of products have cropped up to help guys deal with premature ejaculation. While speaking with a doctor or using specific techniques or sex positions can fix things for you, these options might also be worth a look:

Dynamo Delay Spray

While topical products do come with pros and cons, Dr. Stahl says they can be an effective method to use in preventing premature ejaculation. "Topical therapies are effective," he says. "These products are anesthetic sprays or creams that are applied to the penis to reduce penile sensation. This is an effective therapy that is easy and safe. The potential downside is [the] transfer of the anesthetic agent to the female partner, resulting in some vaginal numbness." Dr. Van Kirk agrees. "Many men have experienced success with delay gels that assist in desensitizing your penis with lidocaine," she says.

Mega 2 Inch Extension

Not only does a penis extender like this one offer more pleasure for your partner, but Dr. Van Kirk also says they work well for men who are dealing with premature ejaculation. "These extensions offer a full stimulation buffer which can inhibit stimulation and allow you to go longer," she says.

Weekend In Bed Bondage Kit

"Focusing on other sensations like some mild bondage can help you focus away from your penis and allow your ejaculations to feel more natural," explains Dr. Van Kirk. This kit from Adam and Eve is great for beginners, and includes bondage toys that are perfect for lighter play.

Svakom Tyler

What Real Men Say: "I've had some success with using cock rings to help me last longer," says Dave, 24. "Oddly enough, the vibrating one that my girlfriend really likes to use has been the one that's been most effective. You'd think the opposite, with the extra stimulation — but the buzzing is actually distracting in a good way, and has kept me from blowing it too soon a few times so far."

5. Techniques To Prevent It

If you're experiencing premature ejaculation, your first move should be to pay a visit to your doctor in order to rule out any health issues that may be causing the problem. Once you've made sure there are no health-related complications, the next step would be to explore a few methods and techniques in order to prevent it.

"The 'squeeze' involves learning to identify when you are beginning to approach orgasm, withdrawing and putting pressure at the base of the head of the penis with thumb on top and fingers underneath," explains Dr. Prause. "This is not really known to do anything physically directly — rather, it is a strategy for learning to decrease/manage increasing sexual sensations with this distraction."

"The stop-start technique is the same idea without the squeeze," says Dr. Prause. "We usually encourage men to start these long before their orgasm is imminent initially, just to get used to doing it and to experience some success in having it work. Then, they can wait later and later in the process to help identify when they need to inhibit their arousal to delay orgasm/ejaculation. These treatments to increase men's control are actually very effective. The stop-start and squeeze techniques both have excellent data for treatment and are safe enough to be tried without oversight by a clinician initially. As with most interventions, it requires collaboration with the partner — understanding, agreeing to systematically stopping intercourse when he feels close, etc., and consistent practice."

As far as holistic techniques go, Nista recommends tantric practices. "Men who apply tantric practices develop mastery over their erections and arousal, stay deeply mindful of their bodies and enjoy pleasure beyond anything that they've experienced before," she says. "At the most basic level, these practices involve a conscious use of relaxation, breath and presence."

Taking time to consciously relax yourself is important in tantric practices, and can also help with premature ejaculation. "When we're relaxed, our sexual energy and arousal can flow freely through the entire body instead of remaining stuck in the genital area," Nista explains. "Men learn early to tense up the muscles in their bodies as they become aroused, and that tension is exactly what triggers the ejaculatory response. When the arousal is stuck in the genitals, held there by muscle tension, it cannot move and soon the pressure becomes too much for the body to hold. As the erotic charge is released, we reach an orgasmic climax and lose all arousal and sexual energy."

Breathing techniques can also be beneficial. "Men often constrict or hold their breath as they become aroused, which is another way to keep the erotic energy localized in the pelvis," says Nista. "This is why tantric men use deep, abdominal breathing to pull their sexual charge out of their genitals and up through their entire bodies. As the arousal is carried by the breath through the entire system, it's much easier to last longer, as the body doesn't struggle to keep a significant amount of pressure in one spot."

Being mindful and in the moment can also help get premature ejaculation under control. "Most men ejaculate early because they're not aware of how aroused they are," says Nista. "With our minds constantly racing, it's challenging to remain mindful and aware of the sensations in the body. But when a man is deeply conscious and connected to his body, he will properly read the signals that his body is sending him and he'll develop not only a better degree of control in bed, but also a deeper sensitivity and an ability to feel much more pleasure."

While these practices take time to master, Nista says putting in the work will be well worth it. "Working with relaxation, breath and presence in a consistent way during masturbation and partner sex will rewire the nervous system and teach the body to remain in the state of arousal for much longer," she says. "This will create a beautiful, effortless experience of lovemaking, full of not only control and pleasure but also connection and deep intimacy. Tantra provides a wonderful alternative to quick, frustrating sexual encounters."

6. Sex Positions That Help Prevent It

Choosing the right sex position strategically can also help with premature ejaculation. According to Brown, the "Yab Yum" position practiced in Tantra is one that's well suited for this. "Yab Yum is where the male is sitting [criss-crossed], with the female partner facing the male sitting on top of him. Her legs are wrapped around his waist, giving both partners control of sensations." This position is also used to get both partner's sexual energies aligned. "Yab Yum aligns the chakras (energy center located in the body) between the couple bringing deep sexual pleasure and awakening," Brown says.

According to sex and relationship expert Dr. Kat Van Kirk, woman on top positions are ideal for men that are dealing with premature ejaculation. Because the woman is in control, it takes the pressure of leading the effort off the man. One position that works particularly well is reverse cowgirl, which limits your visuals to help delay the process. The man lies flat on his back, the woman is on top and facing away from him.

"Water submerged positions where sensation is altered [also work]," says Dr. Van Kirk. If you and your partner haven't tried having sex in a bathtub yet, it might be time to give it a try to see if this method works for you. As far as submerged water sex positions go, the simplest to execute is the "bathtub boogie." To do this, the man sits in the tub with his legs stretched out (or bent if height is an issue). Facing away from him, the woman straddles his lap. To keep her from slipping too much, hold onto her butt or thighs during the act.

Another position that helps prevent premature ejaculation is the side by side. "This position doesn't allow for full penetration and can slow response down," Dr. Van Kirk explains. To do this, both partners lay on their side, and he enters her from behind — kind of like spooning, but you're also having sex.

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